Kidney Cancer: Treatment

Memorial Sloan Kettering physicians make treatment recommendations for kidney tumors based on the specific tumor size, location, and stage of the disease — that is, how large the tumor has grown, how deeply it has invaded the kidney, and whether it has spread to nearby organs, lymph nodes, or another part of the body. Treatment may include surgery, chemotherapy, radiationtherapy, or immunological therapy, alone or in combination.

Surgery

Surgery is the most common form of treatment for kidney tumors, and it is often the only treatment necessary. If an operation is necessary, our team of specialists will do an evaluation and, based on the size and location of the tumor, recommend either removal of the tumor (partial nephrectomy) or of the entire kidney (complete, or radical nephrectomy).(1)

Our team has expertise in both standard open surgical approaches and minimally invasive techniques for kidney cancer. At Memorial Sloan Kettering, the choice of a surgical approach depends on the individual patient and his or her disease.

Minimally invasive surgery, which includes laparoscopic and robotic surgery, is done through small incisions in the abdominal wall using a camera that transmits images to a video monitor. This approach can, in some cases, reduce the time it takes to recover after surgery. Surgeons at Memorial Sloan Kettering have expertise in the latest laparoscopic and robotic approaches for kidney cancer.

When advanced kidney tumors have spread to adjacent organs, surgeons who specialize in the affected area are involved in treatment. Memorial Sloan Kettering's vascular surgeons are available when the cancer has spread to the arteries, veins, and smaller vessels, while our thoracic (chest) surgeons may be called on to remove a tumor that has spread to the lungs.

Because our team includes experts in all aspects of the surgical approach to kidney cancer, we can offer a balanced perspective and can help you make informed decisions about treatment. Memorial Sloan Kettering surgeons have been instrumental in pioneering research in kidney-sparing surgery, and we make every effort to preserve as much of the healthy kidney as possible.(2),(3)

Partial Nephrectomy: Kidney-Sparing Surgery

Kidney-sparing (or nephron-sparing) surgery is a procedure in which a kidney tumor is removed, leaving a margin of normal kidney tissue in order to preserve the function of the remaining kidney. Studies conducted at Memorial Sloan Kettering and other institutions have demonstrated that partial nephrectomy yields comparable results to complete nephrectomy in patients with small tumors (less than 4 centimeters), while maintaining functioning kidney tissue.

Our surgeons are experienced in performing these technically demanding operations. In appropriate situations, our team can also offer laparoscopic partial nephrectomy. In 2009, our surgeons performed 280 partial nephrectomy procedures, 80 of which were done laparoscopically.

Complete (Radical) Nephrectomy

In some situations, the entire kidney needs to be removed. Tumors that require complete nephrectomy tend to be larger in size and to have advanced locally, though sometimes they have spread to another part of the body. Our team can help determine whether patients with such tumors would be best served by laparoscopic or open nephrectomy. Because we are able to offer all possible modes of treatment, we can tailor the approach to each individual patient. In 2009, Memorial Sloan Kettering surgeons performed 97 radical nephrectomies.

For transitional cellcarcinoma of the kidneys and ureters, surgical approaches include removing the kidney and ureter (nephroureterectomy) and partially removing the ureter (segmental resection). These procedures can also be performed laparoscopically, including with robotic-assisted surgery, using smaller incisions. When transitional cell carcinoma is found on the surface of the renal pelvis or ureter, it may be possible to spare the kidney with laser surgery, which uses a narrow beam of light to remove cancer cells from inside the kidney.

During surgery, the doctor may remove nearby lymph nodes to examine them for cancer cells. Pathologists then examine the tumor cells to determine which type of cancer is present.

Image-Guided Ablation

For patients with small tumors who may not be ideal surgical candidates, we offer image-guided ablation of kidney cancers. Instead of making surgical incisions, the doctor places small needles through the skin and uses x-rays to guide them into the cancer. These needles can then freeze (cryoablation) or boil (radiofrequency ablation, or RFA) the cancer, eliminating the tumor. The body is then able to remove the dead tissue, leaving scar tissue behind in its place. These procedures are well tolerated, making ablation a good alternative in nonsurgical patients.

Thermal ablation can also be used as a palliative treatment to relieve painful symptoms when kidney cancer has metastasized to the bone. In these cases the freezing temperatures “anesthetize” the painful site.

Systemic (Whole-Body) Therapy

For kidney tumors that have spread, or metastasized, outside the kidney, our surgeons consult with medical oncologists to determine if systemic (whole-body) treatment, such as chemotherapy, is required before or after surgical removal of the kidney.

Kidney cancer does not, in general, respond well to traditional chemotherapy drugs. Until recently, treatment relied upon interleukin-2 (IL-2) and interferon, drugs that boost the immune system while helping it to recognize and attack kidney cancer cells. Improved understanding of how kidney cancer develops has led to recent advances in immunotherapy withwhat are called targeted therapies (also known as signal transduction inhibitors). As a result, treatment options have improved dramatically over the last few years as new inhibitors and antibodies that block factors important to kidney cancer growth have shown excellent responses and/or prolonged survival compared to interferon and IL-2.

Since 2005, research at Memorial Sloan Kettering and elsewhere has led to five new U.S. Food and DrugAdministration (FDA)-approved therapies for the treatment of advanced kidney cancer: sorafenib (Nexavar®, FDA approved in December 2005), sunitinib (Sutent®, FDA approved in January 2006), temsirolimus (Torisel™, FDA approved in May 2007), everolimus (Afinitor®, FDA approved in March 2009), and the combination of interferon with bevacizumab (Avastin®, FDA approved July 2009). Our clinical investigation program includes strategies to improve upon the responses of kidney cancer to these new drugs, to determine in what order to use them, and to study new agents.

Medical oncologists at Memorial Sloan Kettering developed a model(4),(5) that has become a standard method for assessing risk for patients with metastaticrenal cell carcinoma. It considers factors including the Karnofsky performance status, the time from diagnosis to treatment with interferon, hemoglobin levels, lactate dehydrogenase levels, and corrected serumcalcium to determine whether an individual patient has low, intermediate, or poor risk. An independent study by the Cleveland Clinic(6) confirmed these criteria. This model can help in defining appropriate treatment strategies for people with metastatic disease.

Conventional, or clear cell, renal cancer does not respond to traditional chemotherapy, but it does respond to targeted therapies. For clear cell kidney cancer, clinical studies have compared several targeted therapies (sunitinib, temsirolimus, sorafenib, and the combination of bevacizumab plus interferon) with interferon and have shown that these treatments are as good as or better than interferon alone. For non-clear cell subtypes, less is known about the effectiveness of such therapies. For patients whose tumor has grown while on a targeted therapy, less is known about how best to treat the tumor. Results of a clinical study have shown that everolimus slows tumor growth after sunitinib or sorafenib have stopped working.

Transitional cell carcinoma is sensitive to chemotherapy, and chemotherapy is used to treat patients with advanced cancer of this type. More information on treating transitional cell carcinoma can be found on our Web site in the section on bladder cancer.

Recent evidence suggests that even patients with metastatic kidney cancer can benefit from surgical removal of the primary tumor before starting systemic therapy.(7) Together with Memorial Sloan Kettering surgeons, our medical oncologists can help determine the best treatment approach for each individual patient.

For patients who need systemic therapy, Memorial Sloan Kettering investigators have established an active program of clinical trials designed to explore novel treatment approaches. Investigational approaches are sometimes offered to eligible patients through the clinical trial process.

Radiation Therapy

Radiation therapy is sometimes given as primary treatment for patients who are not well enough to undergo surgery. At Memorial Sloan Kettering Cancer Center, we have used image-guided radiation therapy (IGRT) very successfully to treat kidney cancers that have metastasized. IGRT employs high-precision radiation beams to kill cancer cells while causing less damage to the healthy tissues surrounding a tumor than other radiation treatments. It has been used in many parts of the body, including the brain, spine, lung, and liver. IGRT is not an invasive treatment, and almost always can be given on an outpatient basis.

Because the radiation is very focused and given with high precision, side effects are usually mild. The radiation dose with IGRT is very concentrated, which is the best way to kill most kidney cancer cells. It can also be given in a limited number of treatments (usually between one and five daily treatments), and in coordination with chemotherapy or between cycles of chemotherapy.

abdominal (ab-DAH-mih-nul)

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

ablation (a-BLAY-shun)

In medicine, the removal or destruction of a body part or tissue or its function. Ablation may be performed by surgery, hormones, drugs, radiofrequency, heat, or other methods.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

administration (ad-MIH-nih-STRAY-shun)

In medicine, the act of giving a treatment, such as a drug, to a patient. It can also refer to the way it is given, the dose, or how often it is given.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

advanced cancer (ad-VANST KAN-ser)

Cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

affected

Individuals in a pedigree who exhibit the specific phenotype under study.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

bevacizumab (beh-vuh-SIH-zoo-mab)

A drug used to treat glioblastoma (a type of brain cancer) and certain types of colorectal cancer, lung cancer, and kidney cancer. It is also being studied in the treatment of other types of cancer. Bevacizumab binds to a protein called vascular endothelial growth factor (VEGF). This may prevent the growth of new blood vessels that tumors need to grow. It is a type of antiangiogenesis agent and a type of monoclonal antibody. Also called Avastin.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

calcium (KAL-see-um)

A mineral needed for healthy teeth, bones, and other body tissues. It is the most common mineral in the body. A deposit of calcium in body tissues, such as breast tissue, may be a sign of disease.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

cancer (KAN-ser)

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

carcinoma (KAR-sih-NOH-muh)

Cancer that begins in the skin or in tissues that line or cover internal organs.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

cell (sel)

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

chemotherapy (KEE-moh-THAYR-uh-pee)

Treatment with drugs that kill cancer cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

clear cell (kleer sel)

A type of cell that looks clear inside when viewed under a microscope.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

clinical (KLIH-nih-kul)

Having to do with the examination and treatment of patients.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

clinical study (KLIH-nih-kul STUH-dee)

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical trial.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

clinical trial (KLIH-nih-kul TRY-ul)

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

diagnosis (DY-ug-NOH-sis)

The process of identifying a disease, such as cancer, from its signs and symptoms.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

dose (dose)

The amount of medicine taken, or radiation given, at one time.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

drug (drug)

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

everolimus (eh-veh-ROH-lih-mus)

A drug used to treat certain types of pancreatic cancer. It is also used to treat a type of advanced kidney cancer and to treat subependymal giant cell astrocytoma in some patients. It is being studied in the treatment of other types of cancer and other conditions. Everolimus stops cancer cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. It also lowers the body’s immune response. It is a type of kinase inhibitor, a type of angiogenesis inhibitor, and a type of immunosuppressant. Also called Afinitor and RAD001.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

FDA

An agency in the U.S. federal government whose mission is to protect public health by making sure that food, cosmetics, and nutritional supplements are safe to use and truthfully labeled. The FDA also makes sure that drugs, medical devices, and equipment are safe and effective, and that blood for transfusions and transplant tissue are safe. Also called Food and Drug Administration.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

hemoglobin (HEE-moh-GLOH-bin)

The substance inside red blood cells that binds to oxygen in the lungs and carries it to the tissues.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

IGRT

A procedure that uses a computer to create a picture of a tumor to help guide the radiation beam during radiation therapy. The pictures are made using CT, ultrasound, X-ray, or other imaging techniques. IGRT makes radiation therapy more accurate and causes less damage to healthy tissue. Also called image-guided radiation therapy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

IL-2

One of a group of related proteins made by leukocytes (white blood cells) and other cells in the body. IL-2 is made by a type of T lymphocyte. It increases the growth and activity of other T lymphocytes and B lymphocytes, and affects the development of the immune system. Aldesleukin (IL-2 made in the laboratory) is being used as a biological response modifier to boost the immune system in cancer therapy. IL-2 is a type of cytokine. Also called interleukin-2.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

A procedure that uses a computer to create a picture of a tumor to help guide the radiation beam during radiation therapy. The pictures are made using CT, ultrasound, X-ray, or other imaging techniques. Image-guided radiation therapy makes radiation therapy more accurate and causes less damage to healthy tissue. Also called IGRT.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

immune system (ih-MYOON SIS-tem)

The complex group of organs and cells that defends the body against infections and other diseases.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

immunotherapy (IH-myoo-noh-THAYR-uh-pee)

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in immunotherapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biological therapy, biotherapy, and BRM therapy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

interferon (in-ter-FEER-on)

A biological response modifier (a substance that can improve the body's natural response to infections and other diseases). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and -gamma. The body normally produces these substances. They are also made in the laboratory to treat cancer and other diseases.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

interleukin-2 (in-ter-LOO-kin...)

One of a group of related proteins made by leukocytes (white blood cells) and other cells in the body. Interleukin-2 is made by a type of T lymphocyte. It increases the growth and activity of other T lymphocytes and B lymphocytes, and affects the development of the immune system. Aldesleukin (interleukin-2 made in the laboratory) is being used as a biological response modifier to boost the immune system in cancer therapy. Interleukin-2 is a type of cytokine. Also called IL-2.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

investigational (in-VES-tih-GAY-shuh-nul)

In clinical trials, refers to a drug (including a new drug, dose, combination, or route of administration) or procedure that has undergone basic laboratory testing and received approval from the U.S. Food and Drug Administration (FDA) to be tested in human subjects. A drug or procedure may be approved by the FDA for use in one disease or condition, but be considered investigational in other diseases or conditions. Also called experimental.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

Karnofsky Performance Status (kar-NOF-skee per-FOR-munts STA-tus)

A standard way of measuring the ability of cancer patients to perform ordinary tasks. The Karnofsky Performance scores range from 0 to 100. A higher score means the patient is better able to carry out daily activities. KPS may be used to determine a patient's prognosis, to measure changes in a patient’s ability to function, or to decide if a patient could be included in a clinical trial. Also called KPS.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

kidney (KID-nee)

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

kidney cancer (KID-nee KAN-ser)

Cancer that forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms tumor, which is a type of kidney cancer that usually develops in children under the age of 5.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

lactate dehydrogenase (LAK-tayt dee-hy-DRAH-jeh-nays)

One of a group of enzymes found in the blood and other body tissues and involved in energy production in cells. An increased amount of lactate dehydrogenase in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactic acid dehydrogenase and LDH.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

laser (LAY-zer)

A device that forms light into intense, narrow beams that may be used to cut or destroy tissue, such as cancer tissue. It may also be used to reduce lymphedema (swelling caused by a buildup of lymph fluid in tissue) after breast cancer surgery. Lasers are used in microsurgery, photodynamic therapy, and many other procedures to diagnose and treat disease.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

liver (LIH-ver)

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

lung (lung)

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

lymph (limf)

The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

margin (MAR-jin)

The edge or border of the tissue removed in cancer surgery. The margin is described as negative or clean when the pathologist finds no cancer cells at the edge of the tissue, suggesting that all of the cancer has been removed. The margin is described as positive or involved when the pathologist finds cancer cells at the edge of the tissue, suggesting that all of the cancer has not been removed.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

metastatic (meh-tuh-STA-tik)

Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

monitor (MAH-nih-ter)

In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

nephrectomy (neh-FREK-toh-mee)

Surgery to remove a kidney or part of a kidney. In a partial nephrectomy, part of one kidney or a tumor is removed, but not an entire kidney. In a simple nephrectomy, one kidney is removed. In a radical nephrectomy, an entire kidney, nearby adrenal gland and lymph nodes, and other surrounding tissue are removed. In a bilateral nephrectomy, both kidneys are removed.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

outpatient (OWT-pay-shunt)

A patient who visits a health care facility for diagnosis or treatment without spending the night. Sometimes called a day patient.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

partial nephrectomy (PAR-shul neh-FREK-toh-mee)

Surgery to remove part of one kidney or a kidney tumor, but not an entire kidney.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

pelvis (PEL-vus)

The lower part of the abdomen, located between the hip bones.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

primary treatment (PRY-mayr-ee TREET-ment)

Initial treatment used to reduce a cancer. Primary treatment is followed by other treatments, such as chemotherapy, radiation therapy, and hormone therapy to get rid of cancer that remains. Also called first-line therapy, induction therapy, and primary therapy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

primary tumor (PRY-mayr-ee TOO-mer)

The original tumor.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

radiation (RAY-dee-AY-shun)

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

recover (ree-KUH-ver)

To become well and healthy again.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

renal cell carcinoma (REE-nul sel KAR-sih-NOH-muh)

The most common type of kidney cancer. It begins in the lining of the renal tubules in the kidney. The renal tubules filter the blood and produce urine. Also called hypernephroma, renal cell adenocarcinoma, and renal cell cancer.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

scar tissue (skar TIH-shoo)

Fibrous tissue that forms when a wound heals.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

serum (SEER-um)

The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

signal transduction (SIG-nul tranz-DUK-shun)

The process by which a cell responds to substances in its environment. The binding of a substance to a molecule on the surface of a cell causes signals to be passed from one molecule to another inside the cell. These signals can affect many functions of the cell, including cell division and cell death. Cells that have permanent changes in signal transduction molecules may develop into cancer.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

sorafenib (sor-A-feh-nib)

A drug used to treat advanced kidney cancer and a type of liver cancer that cannot be removed by surgery. It is also being studied in the treatment of other types of cancer. Sorafenib stops cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. It is a type of kinase inhibitor and a type of antiangiogenesis agent. Also called BAY 43-9006, Nexavar, and sorafenib tosylate.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

spine (spine)

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spine encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and vertebral column.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

stage (stayj)

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

sunitinib (soo-NIH-tih-nib)

A drug used to treat certain types of pancreatic cancer. It is also used to treat gastrointestinal stromal tumors (GIST) in some patients and to treat advanced kidney cancer. It is being studied in the treatment of other types of cancer. Sunitinib stops cancer cells from dividing and may prevent the growth of new blood vessels that tumors need to grow. It is a type of tyrosine kinase inhibitor and a type of angiogenesis inhibitor. Also called SU011248, SU11248, sunitinib malate, and Sutent.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

surgery (SER-juh-ree)

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

systemic (sis-TEH-mik)

Affecting the entire body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

systemic therapy (sis-TEH-mik THAYR-uh-pee)

Treatment using substances that travel through the bloodstream, reaching and affecting cells all over the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

targeted therapy (TAR-geh-ted THAYR-uh-pee)

A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

temsirolimus (TEM-sih-ROH-lih-mus)

A drug used to treat advanced renal cell carcinoma (a type of kidney cancer). It is also being studied in the treatment of other types of cancer. Temsirolimus blocks a protein involved in cell division, and may kill cancer cells. It is a type of rapamycin analog and a type of serine/threonine kinase inhibitor. Also called CCI-779 and Torisel.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

therapy (THAYR-uh-pee)

Treatment.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

thermal ablation (THER-mul a-BLAY-shun)

A procedure using heat to remove tissue or a part of the body, or destroy its function. For example, to remove the lining of the uterus, a catheter is inserted through the cervix into the uterus, a balloon at the end of the catheter is inflated, and fluid inside the balloon is heated to destroy the lining of the uterus.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

thoracic (thor-A-sik)

Having to do with the chest.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

tissue (TIH-shoo)

A group or layer of cells that work together to perform a specific function.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

transitional cell (tran-ZIH-shuh-nul sel)

A cell that varies in shape depending on whether the tissue is being stretched. Transitional cells may be stretched without breaking apart. They line hollow organs such as the bladder.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

tumor (TOO-mer)

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

ureter (YER-eh-ter)

The tube that carries urine from the kidney to the bladder.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

will (wil)

A legal document in which a person states what is to be done with his or her property after death, who is to carry out the terms of the will, and who is to care for any minor children.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)